1,721,055 research outputs found
Methodological concerns on 'Assessment of ovarian reserve after cystectomy versus "one-step" laser vaporization in the treatment of ovarian endometrioma: A small randomized clinical trial'
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Value of Urodynamics Before Stress Urinary Incontinence Surgery: A Randomized Controlled Trial To the Editor:
No full textOther imaging techniques: Double-contrast barium enema, endoscopic ultrasonography, multidetector CT enema, and computed tomography colonoscopy
No full textDouble-contrast barium enema (DCBE), transrectal endoscopic ultrasonography (REU), multidetector computerized tomography enema (MDCT-e), and computed tomography colonoscopy (CTC) have been successfully used for the diagnosis of bowel endometriosis. DCBE provides a complete overview of the entire colon and allows detecting cecal nodules. The accuracy of DCBE is operator dependent and, thus, it may have low specificity. It does not allow identifying the cause of the mass effect. DCBE requires the administration of barium and exposure to radiation. REU precisely estimates the distance between the rectosigmoid nodule and the anal verge. However, it allows investigating only the distal part of rectosigmoid, it misses anterior pelvic lesions, and it has poor sensitivity for the diagnosis of endometriomas. MDCT-e is accurate and reproducible in diagnosing intestinal endometriosis and in assessing its characteristics: the largest diameter of the nodule, the distance between the distal part of the nodule and the anal verge, and depth of infiltration of endometriosis in the intestinal wall. MDCT-e requires the administration of iodinated contrast medium (CM) and the exposure to radiations. CTC has good performance in the diagnosis of rectosigmoid endometriosis. It allows estimating the degree of intestinal stenosis CTC, and the distance between the intestinal endometriotic nodule and the anal verge. It requires exposure to radiations, and it may require the administration of an iodinated CM
Norethisterone acetate versus norethisterone acetate combined with letrozole for the treatment of ovarian endometriotic cysts: a patient preference study
No full textObjective: To compare the efficacy of norethisterone acetate (NETA; group N) or letrozole combined with NETA (group L) in treating endometriotic ovarian cysts.
Study design: This patient-preference study included 20 patients in group N and 20 patients in group L. The primary aim of the study was to compare the volume of the endometriomas during and after treatment. The secondary outcome was the evaluation of the changes in pain symptoms during and after treatment.
Results: After six months of treatment, the volume of the endometriomas significantly decreased compared with baseline in both study groups; it was smaller in group L than in group N (p = 0.026). The rate of satisfied patients at six months of treatment was similar between the study groups (p = 0.451). No significant difference was reported between the two study groups in the amelioration of pain symptoms and in the incidence of adverse events.
Conclusions: LetrozolecombinedwithNETAismoreefficaciousthanNETAaloneinreducingthevolume of endometriotic cysts but in none of the 40 patients included in the study did the endometriomas disappear. The efficacy of aromatase inhibitors, however, should be balanced with the need to administer long-term treatment
Endometriotic ovarian cysts do not negatively affect the rate of spontaneous ovulation
No full textStudy question: Do endometriotic ovarian cysts influence the rate of spontaneous ovulation? Summary answer: Endometriotic cysts, no matter what their volume, do not influence the rate of spontaneous ovulation in the affected ovary. What is known already: Endometriotic ovarian cysts may negatively affect spontaneous ovulation in the affected ovary. Study design, size, duration: This was a prospective observational study performed between September 2009 and June 2013. Participants/materials, setting, methods: This study included women of reproductive age with regular menstrual cycles and unilateral ovarian endometriomas (diameter≥20 mm)desiring to conceive. Exclusion criteria were: hormonal therapies in the 3 months prior to study entry and previous adnexal surgery. Patients underwent serial transvaginal ultrasound to assess the side of ovulation (for up to six cycles). Main results and the role of chance: Ovulation was monitored in 1199 cycles in 244 women (age, mean±SD, 34.3±4.9 years). 55.3% of the patients had left endometriomas and 44.7% had right endometriomas (P = 0.024). The mean (±SD) diameter of the endometriomas was 5.3 cm (±1.7 cm). Ultrasonographically documented ovulation occurred in 596 cycles in the healthy ovary (49.7%; 95% CI, 46.8-52.6%) and in 603 cycles in the affected ovary (50.3%; 95% CI, 47.1-53.2%; P = 0.919). This observation was confirmed in patients with diameter of the cyst ≥4 cm(n = 166) and in those with diameter of the cyst ≥6 cm(n = 45). One hundred and five patients spontaneously conceived (43.0%; 95% CI, 36.7-49.5%). Limitations, reason for caution: The high pregnancy rate reported in this study wasobserved in a selected population of women with endometriomas and cannot be extrapolated to all patients with endometriosis. Wider implications of the findings: Since ovarian endometriomas do not impair spontaneous ovulation, the impact on fertility of surgical excision of ovarian endometriomas should be further investigated
Aberrant right subclavian artery in fetuses with Down syndrome: a systematic review and meta-analysis.
No full textImpact of endometriomas and deep infiltrating endometriosis on pregnancy outcomes and on first and second trimester markers of impaired placentation
No full textBackground and objective: Previous studies did not draw a definitive conclusion about the influence of the role of deep endometriosis (DE) and ovarian endometrioma (OE) as risk factor for developing adverse perinatal outcomes in patients affected by endometriosis. This study aimed to investigate if adverse fetal and maternal outcomes, and in particular the incidence of small for gestational age (SGA) infants, are different in pregnant women with OE versus pregnant women with DE without OE. Material and methods: This study was based on a retrospective analysis of a database collected prospectively. The population included in the study was divided into three groups: Patients with OE, patients with DE without concomitant OE, and patients without endometriosis (controls). The controls were matched on the basis of age and parity. Demographic data at baseline and pregnancy outcomes were recorded. Results: There was no statistically significant difference in first trimester levels of PAPP-A, first and mid-pregnancy trimester mean Uterine Artery Doppler pulsatile index, estimated fetal weight centile, and SGA fetuses’ prevalence for patients with OE, and those with DE without OE in comparison to health women; moreover, there was no statistically significant difference with regard to SGA birth prevalence, prevalence of preeclampsia, and five-minute Apgar score between these three groups. Conclusions: The specific presence of OE or DE in pregnant women does not seem to be associated with an increased risk of delivering an SGA infant. These data seem to suggest that patients with endometriosis should be treated in pregnancy as the general population, thus not needing a closer monitoring
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